Different Smoking Statuses on Survival and Emphysema in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease

Abstract

Objective To investigate the association between different smoking statuses and survival and emphysema in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods This retrospective study included patients admitted from October 2014 to September 2017. Demographic, clinical, laboratory, imaging, impulse oscillometry, and traditional pulmonary function data were collected. The relationship between smoking and EI was analyzed via binary logistic regression after adjusting for other factors. Survival was analyzed using the Kaplan–Meier method and the log rank test. Results The patients with AECOPD (357 cases) were identified (and stratified into three groups: never smoked (NS; n=83), former smokers (FS, n=118), and current smokers (CS; n=156). Compared with CS, NS were older and predominantly female. No differences were observed in respiratory symptoms and acute exacerbation between CS and NS. NS had higher resistance and reaction in the central and peripheral airways, while CS exhibited more severe diffuse dysfunction. CS demonstrated more severe and extensive emphysema. Smoking was an independent risk factor for emphysema after adjusting for age, forced expiratory volume in the first second over predicted value, BMI, leukocyte count, and carbon monoxide transfer coefficient. No difference in 5-year survival rates between NS and CS was established. Conclusion CS has the worst pulmonary function, suggesting a more important destruction of the lung parenchyma, while AECOPD without smoking risk factors mostly affects the airways. Impulse oscillometry can be used for imaging airway-dominant AECOPD. There was no difference in the 5-year survival rate.

Acute exacerbations of chronic obstructive pulmonary disease in a cohort of Chinese never smokers goes along with decreased risks of recurrent acute exacerbation, emphysema and comorbidity of lung cancer as well as decreased levels of circulating eosinophils and basophils

“…Another smoking status-associated clinical characteristic is emphysema, with a higher prevalence of emphysema in smokers than in non-smokers in AECOPD. This result is in line with findings from a very recent study, in which Ding et al demonstrated that smokers in AECOPD exhibit more severe diffuse dysfunction than never smokers and cigarette smoking represents an independent risk factor for emphysema ( 13 ). In COPD, emphysema is a consequence of chronic inflammatory and consequent destructive processes.…”

“…in the same way. In contrast to stable COPD, the association of smoking status with clinical and laboratory phenotypes in patients with AECOPD has only been investigated in few studies with small sample sizes (13,14). In the present study, we aimed to determine the effect of smoking status on demographic, clinical, and laboratory characteristics of AECOPD in a large clinical cohort consisting of 1,034 patients.…”

“…It has been shown in many studies that the two groups of patients with COPD differ in demographic and clinical features ( 7 – 12 ), suggesting that they are different in disease etiology and pathogenesis and thus should not be managed in the same way. In contrast to stable COPD, the association of smoking status with clinical and laboratory phenotypes in patients with AECOPD has only been investigated in few studies with small sample sizes ( 13 , 14 ). In the present study, we aimed to determine the effect of smoking status on demographic, clinical, and laboratory characteristics of AECOPD in a large clinical cohort consisting of 1,034 patients.…”

Relationship between chronic obstructive pulmonary disease and adiponectin concentrations: An updated meta-analysis and single-cell RNA sequencing

“…These 28 articles were downloaded and thoroughly reviewed the full text, excluding 10 articles with insufficient data and overlapping studies, leaving 18 articles Finally, 18 articles covering 24 studies were included. [30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47] The literature selection process is outlined in Figure 1.…”

“…Of the 18 included published papers, [30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47] involving 24 studies containing a total of 1577 COPD patients and 1436 healthy individuals, including 308 acute COPD and 1269 stable COPD patients. The basic information on the included literature is shown in Tables 1 and 2.…”